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The term ‘dementia’ describes a set of symptoms that include:

These symptoms occur when the brain is damaged by certain diseases, such as Alzheimer’s disease, a series of small strokes or other neurological conditions such as Parkinson’s Disease.   

Around 60% of people with dementia have Alzheimer’s disease, which is the most common type of dementia, around 20% have vascular dementia, which results from problems with the blood supply to the brain and many people have a mixture of the two. There are other less commons forms of dementia, for example dementia with Lewy bodies and fronto-temporal dementia. 

Dementia is a growing challenge, as our population continues to age. After the age of 65, the chances of developing dementia doubles every five years. We need to continue to focus on this area as dementia has, and will continue to have, a huge impact on people living with the condition, their carers, families and society more generally. 

Locally, our CCG is performing well in diagnosing  and care planning for people who have dementia and making sure that these people are recorded on GP registers. We want to build on this good work to make sure that there is equitable access to treatment and services for dementia. We are also looking at how we can improve support and treatment for those post-diagnosis. This involves working with our local partners, including Bradford District Care NHS Foundation Trust and the local authority to redesign and transform services. 

We are also working to increase the recognition, prevention and treatment of delirium, recognising that it is a distressing condition and increase cognitive decline to dementia.

Delirium is a condition where people have increased confusion, changes in thinking and a reduced attention span. Symptoms can develop quickly and often fluctuate during the day. Delirium is also known as ‘acute confusion’. It is curable - but if it is undetected then it can be a life-threatening condition.

How are we doing? 

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Prevalence - estimated diagnosis rate for people with dementia

As the global population ages and life expectancy continues to increase, dementia has become a one of the most significant health and care issues. Globally, the number of people living with dementia is estimated to be 44 million – this is predicted to almost double by 2030. In England alone, it is estimated that around 676,000 people live with dementia - although estimating dementia prevalence is not an exact science.

There is a national target for dementia diagnosis. This is set at 67% and is derived from the proportion of people diagnosed with dementia compared to the estimated number of people thought to be living with dementia.

As part of the Bradford Better Care Fund, we have a local indicator for dementia prevalence. This relates to the proportion of people diagnosed with dementia in comparison to the estimated prevalence rate:

Local target - 75% of those expected to have dementia to have a diagnosis recorded.

National target - is set lower than our local target at 67% of those expected to have dementia to have a diagnosis recorded.

In November 2016 the average dementia prevalence rate in England is 68%

Our CCG have diagnosed 83.1%of patients who are expected to have dementia in our population

What we are doing to continue to maintain and improve the diagnosis of dementia

We are working with Bradford District Care NHS Foundation Trust to review the pathway for memory assessment and treatment services. Additional resources have been made available to support the memory assessment and treatment services at the trust. The service is also looking at how to improve efficiency to maximise the use of resources and implement best practice.  We have also worked with Bradford District Care NHS Foundation Trust to increase the level of support available to people recently diagnosed with dementia, their families and their carers.

We want to continue to meet a diagnosis rate of over 75% of the estimated number of people in our population with dementia. Our CCG is performing well in relation to the dementia diagnosis rates and we plan to maintain this performance in 2016/17.

We are also using the national Diadem tool to look for our hidden population living within care homes.

Care planning and post diagnostic support

It is important that people living with dementia feel supported to live in the community for as long as possible. We have focused effort on identifying the proportion of people living with a diagnosis of dementia to offer post-diagnostic support and formal care planning.

People diagnosed with dementia should be offered a face-to-face appointment specifically to review their diagnosis and / or care plan or advanced care plan. This is recommended in Dementia: supporting people with dementia and their carers in health and social care, clinical guidance from the National Institute for Health and Care Excellence (NICE).

For people with dementia in our CCG three out of every four patients (75.9%) had a review in the last 12 months, we want to improve this.

What we are doing to support our GP practices with face-to-face reviews

We have developed and recently refreshed resources for our GP practices so that they can better support patients. This includes a care planning and education package to support your GP practice when doing your annual dementia review and sign post you to appropriate service. For patients, we have developed a 'what makes a difference'. This leaflet helps patients prepare for their appointment with your nurse / GP and helps patients to think about the issues that are most important to them. The Bradford advance care plan booklet has also been developed. This helps patients plan their care and ensure that patients, their family and carers are supported in deciding what care they want for the future. 

What you have told us about dementia services 

We make sure that we are listening, engaging and involving patients in the planning and design of their local NHS. To do this, each programme of work has the infrastructure to engage and collect information from people through:

Dementia service experience

The insight and feedback you give us makes sure that we don't just collect information, but that we have the means and ability to use it to inform our commissioning activity and improve quality. All the insight and feedback is pulled together in a system we call Grass Roots.

Grass Roots

Grass Roots pulls together information reported through NHS Choices, Patient Opinion, Healthwatch, complaints, local groups and direct patient, family and community feedback so that we can understand experiences of local NHS services. This information helps us inform our CCG planning and decision making. 

Dementia - grassroots

Patient stories

Our CCG has funded the localisation of a website dedicated to supporting carers of those living with dementia. The Dementia Carer website has lots of videos from Bradford people who are careres of those living with dementia. These videos capture their experiences of services and other aspects of daily life living with dementia. 

2016/17 - what have we done?

What we are doing in 2017/18 and 2018/19

We plan to work with partners to refresh the dementia strategy. This will make sure that it continues to be relevant and effective for the needs of our population. We will also focus on delirium. We are going to work with local providers to have an increased focus on the recognition, prevention and treatment of delirium.

There is ongoing work towards the evidence based treatment pathway as well as more GP practices in Bradford becoming dementia friendly.

What we are doing over the next five years

Over the next five years, we plan to build on the strong foundation that we have already developed for people living with dementia, their families and their carers.  

Our vision

Dementia - the next five years

To achieve this vision, we will be looking at two main areas:

Improving care and quality of services

There are a number of measures that we will be taking to improve care for people living with dementia:

Creating a 24/7 integrated system across health and care

The Better Care Fund is enabling us to make a significant change in the capacity and capability of community services. Our ambition is for these community services to become an integrated 24/7 system. This is extensive work which includes delivering:

We are commissioning to the new evidence based treatment pathway expectations..